Ikhisemojie Sylvester O, Ademuyiwa Adesoji O, Bode Chris O, Mofikoya Bolaji O
Department of Surgery, Paediatric Surgery Unit, Randle General Hospital, Lagos State Hospital Management Board, Surulere, Lagos, Nigeria.
Department of Surgery, Paediatric Surgery Unit, College of Medicine, University of Lagos, Idi Araba, Lagos, Nigeria.
Afr J Paediatr Surg. 2017 Jan-Mar;14(1):5-7. doi: 10.4103/ajps.AJPS_19_16.
The Plastibell is the most popular circumcision method among mothers in our city. Haemorrhage is its major problem. At our centre, we have recorded many circumcision problems resulting from prolonged retention of the Plastibell ring and this study, therefore, sought to explore the ways of reducing complications resulting from prolonged retention of the ring.
This was a prospective study, in which a total of sixty consecutive male neonates were recruited with all undergoing circumcision using the Plastibell device. Thirty patients were assigned to the subject group, in whom the Plastibell ring was removed by the investigator at 24 h while the other thirty constituted the control group whose Plastibell rings were allowed to fall off on their own. The patients selected were aged between 7 and 28 days.
Overall, 4 (6.6%) of the sixty neonatal circumcisions in this study were complicated by haemorrhage. There was minor bleeding in 3 (10%) of the thirty subjects and 1 (3.3%) of the thirty controls. There was no statistically significant difference between the groups (P = 0.3006). One patient each from the subject and control groups bled following slipped ligature a few hours after Plastibell circumcision. The other two patients in the subject group bled following the removal of the Plastibell ring at 24 h. All the bleeding episodes were effectively controlled within 5 min by firm digital pressure only administered through a piece of dry, sterile gauze.
Post-circumcision haemorrhage was not significantly different between circumcised babies whose Plastibell rings were removed at 24 h and those in whom it was left to fall off on its own.
包皮环套术是我市母亲们最常用的包皮环切术方法。出血是其主要问题。在我们中心，我们记录了许多因包皮环套长时间留存导致的包皮环切问题，因此，本研究旨在探索减少因环套长时间留存而导致并发症的方法。
这是一项前瞻性研究，共纳入60例连续的男性新生儿，均采用包皮环套装置进行包皮环切术。30例患者被分配到试验组，由研究者在24小时时拆除包皮环套，另外30例构成对照组，其包皮环套任其自然脱落。入选患者年龄在7至28天之间。
总体而言，本研究中60例新生儿包皮环切术中4例（6.6%）出现出血并发症。试验组30例中有3例（10%）出现轻微出血，对照组30例中有1例（3.3%）出现轻微出血。两组之间无统计学显著差异（P = 0.3006）。试验组和对照组各有1例患者在包皮环套环切术后数小时因结扎滑脱而出血。试验组的另外2例患者在24小时拆除包皮环套后出血。所有出血事件仅通过一块干燥无菌纱布施加的有力指压在5分钟内得到有效控制。
在24小时拆除包皮环套的包皮环切婴儿与任其自行脱落的婴儿之间，包皮环切术后出血情况无显著差异。
